Publication Date

8-15-2016

Keywords

patient satisfaction, racial/ethnic differences

Abstract

Background/Aims: Asians now exceed Latinos as the highest proportion of new immigrants in the United States, totaling over 18 million. Asian patients report lower satisfaction with their health care than do non-Hispanic white (NHW) patients. The goal of this comparative, mixed-methods study was to explore Asian patients’ expectations and experiences with health care compared to NHW patients as well as how cultural norms related to evaluation may contribute to lower patient satisfaction among Asians.

Methods: From July 2014 to August 2015 we conducted a comparative mixed-methods study with Chinese, South Asian and NHW patients from a large multispecialty clinic in Northern California. Electronic health records were used to select patients for recruitment, and invitations were sent via letter, phone and/or email. Chinese patients include those whose preferred language was Mandarin, Cantonese or English. As English is widely spoken among the South Asian patient population, these patients were screened for acculturation at recruitment to include equal numbers of high- and low-acculturation patients. Patients participated in either a focus group or cognitive interview, and all participants completed surveys including demographics and standardized measures of acculturation, health care expectations and satisfaction. Focus group participants discussed their expectations and experiences of care, while cognitive interview participants shared the cognitive processes underlying their evaluation of a standardized health care visit vignette. Focus groups and surveys for Chinese patients were conducted in their preferred language. All cognitive interviews were conducted in English.